Circulation, Vol 74, 164-172, Copyright © 1986 by American Heart Association
JH Myers, MC Stirling, M Choy, AJ Buda and KP Gallagher
Simple geometric models of the left ventricle and indirect experimental
measurements suggest that the inner myocardial wall contributes the largest
fraction to total wall thickening. We measured transmural differences in
regional wall thickening directly, using an epicardial M mode
echocardiographic transducer (6 mm diameter, 5 MHz) placed on the anterior
free wall of the left ventricle. Wall thickness was partitioned into inner
and outer regions by inserting a waxed, 3-0 suture at different depths
within the wall. The suture was used as an intramural echo target that was
imaged simultaneously with the endocardium to determine inner and outer
fractional contribution to total wall thickness. Data were collected in
open-chest dogs at rest, during inotropic stimulation with isoproterenol,
and during right heart bypass, which was used to vary cardiac output and
preload. Results obtained with this method demonstrated that systolic wall
thickness was nonuniform at rest and during each intervention. The
fractional contributions to total wall thickening of the inner, middle, and
outer thirds of the myocardial wall were estimated from the data to be 58%,
25%, and 17%, respectively. The experimental findings corresponded closely
to theoretical predictions, supporting the conclusion that a gradient of
thickening exists across the myocardial wall, with the inner portion of the
wall contributing the largest fraction to total systolic thickening.
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Direct measurement of inner and outer wall thickening dynamics with epicardial echocardiography
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